Surgeons restore full ambulatory ability in double-amputee teenager with flesh-eating disease

In a medical first in Quebec, Dr. Panagiotis (Peter) Glavas and his team at CHU Sainte-Justine and Universite de Montreal have managed to restore full ambulatory ability in a severely handicapped teenager who was left a double-amputee after getting flesh-eating disease in infancy.

Through a series of complex procedures unprecedented in pediatric orthopedic surgery in this province, and in collaboration with a company specializing in advanced orthopedic solutions, Dr. Glavas used a special 3D bone-cutting guide of his own design to facilitate the surgery.

The result of the operation on one of the boy's partly amputated legs in May 2019 was so encouraging – the patient was able to finally walk properly with a custom-fitted prosthesis – another is scheduled for Jan. 21 to fix his other leg.

A dramatic story

In January 2005, at 18 months, baby Charlie was attacked by flesh-eating bacteria. Despite the efforts of caregivers, he had to have both legs amputated at the middle of the shinbone, or tibia. Although Charlie's life was saved, the bacteria had time to infect other cells, in particular those essential to proper bone growth. Gradually, the bones of Charlie's amputated legs started growing at an abnormal angle, making it difficult and extremely painful to wear a prosthesis.

Over the years that followed and during his adolescence, Charlie underwent multiple surgeries to correct the malformed tibia bones, with limited success. As he grew, his deformity finally made it impossible to attach an effective prosthesis. The pain from wearing ones that were poorly adapted to his particular condition became so great that Charlie gave up trying to walk and wound up back in his wheelchair.

In late adolescence, when Charlie stopped growing, Dr. Glavas, in collaboration with the Quebec company Bodycad, looked for a way to straighten the boy's left tibia in order to fit him with a comfortable prosthesis. The surgery would take multiple saw strokes, and the challenge was to find the exact way to straighten the bone without weakening it. That's where the new 3D cutting guide came in.

After 200 hours of fine-tuning the device, in May 2019 Dr. Glavas positioned it on the boy's left tibia and began the operation, now satisfied his saw cuts would be extremely precise. Subsequently, to stabilize the tibia Charlie was fitted with a custom-made plate adapted to the specific anatomy of the remaining bone. Once the boy was walking again, further evaluations were made.

In August, after reviewing their tests assessing Charlie's gait, the medical team decided the results were encouraging enough to repeat the operation in January, this time on his right tibia.

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